Table of Contents

SQUASH (raw data)

The Short questionnaire to Assess Health-enhancing physical activity (SQUASH) is a Dutch questionnaire developed by the Dutch National Institute of Public Health and the Environment to give an indication of habitual physical activity levels (section: lifestyle & environment).
The SQUASH was structured to enable the assessment of compliance to physical activity guidelines: the Dutch Healthy Exercise Norm. These guidelines are different for children (<18 years), adults (18-55 years), and older adults (>55 years), see table below.

Age group Light intensity Moderate intensity Vigorous intensity
Youth (<18 years) <5 MET 5 - 8 MET >8 MET
Adults (18 - 55 years) <4 MET 4 - 6,5 MET >6,5 MET
Older Adults (>55 years) <3 MET 3 - 5 MET >5 MET

SQUASH in Lifelines

Lifelines implemented the SQUASH in 1A Questionnaire 2, 2A Questionnaire 1 and 3A Questionnaire 1. In 1B, 1C and 3B, participants were only asked a very general question about their physical activity level.
Note that the full squash was also implemented in additional assessment NEXT. Two general questions from the SQUASH were asked in the additional questionnaire on daily activities (ACTQ).

SQUASH sum scores

The results from 1A were used to calculate SQUASH sum scores. Please follow the link for the calculation protocol and the resulting variables.

Background

Habitual physical activity is measured by asking questions about “an average week in the past months”.
Questions were distributed over 4 categories:

  1. Commuting (incl. walking and bicycling to and from work)
  2. Leisure time (walking, bicycling, gardening, odd jobs and sports)
  3. Household
  4. Work and school

For each category, three main aspects are assessed1):

NB: for household and work/school activities, intensity was measured in light/moderate and vigorous.
NNB: for work/school activities, frequency was omitted from some versions of 1A questionnaire 2.

Protocol

To make it easier for subjects to know which type of activities were applicable, examples of activities were mentioned for sports, household activities, and activities at work2).
Hobbies other than sports, walking/cycling, and gardening were not included in the SQUASH. These activities often have very low MET values (<2 MET), and were therefore considered to contribute negligibly to habitual activity levels.
Note that the SQUASH questionnaire was not designed to measure energy expenditure, but to give an indication of the habitual activity level.

1)
De Hollander E.L., Zwart L, De Vries S.I., Wendel-Vos G.C.W. The SQUASH was a more valid tool than the OBiN for categorizing adults according to the Dutch physical activity and the combined guideline. Journal of Clinical Epidemiology 65 (2012) 73e81
2)
Wendel-Vos G.C.W., Schuit A.J., Saris W.H.M., Kromhout D. Reproducibility and relative validity of the Short Questionnaire to Assess Health-enhancing physical activity. Journal of Clinical Epidemiology 56 (2003) 1163–1169